Dataset Information

Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians.

ABSTRACT:

Background

Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is of great global public health concern.

Objective

We explored the clinical management of inpatients with COVID-19 in Italy.

Methods

A self-administered survey was sent by email to Italian physicians caring for adult patients with COVID-19. A panel of experts was selected according to their clinical curricula and their responses were analyzed.

Results

A total of 1,215 physicians completed the survey questionnaire (17.4% response rate). Of these, 188 (15.5%) were COVID-19 experts. Chest computed tomography was the most used method to detect and monitor COVID-19 pneumonia. Most of the experts managed acute respiratory failure with CPAP (56.4%), high flow nasal cannula (18.6%), and non-invasive mechanical ventilation (8%), while an intensivist referral for early intubation was requested in 17% of the cases. Hydroxychloroquine was prescribed as an antiviral in 90% of cases, both as monotherapy (11.7%), and combined with protease inhibitors (43.6%) or azithromycin (36.2%). The experts unanimously prescribed low-molecular-weight heparin to patients with severe COVID-19 pneumonia, and half of them (51.6%) used a dose higher than standard. The respiratory burden in patients who survived the acute phase was estimated as relevant in 28.2% of the cases, modest in 39.4%, and negligible in 9%.

Conclusions

In our survey some major topics, such as the role of non-invasive respiratory support and drug treatments, show disagreement between experts, likely reflecting the absence of high-quality evidence studies. Considering the significant respiratory sequelae reported following COVID-19, proper respiratory and physical therapy programs should be promptly made available.

SUBMITTER: Attanasi M

PROVIDER: S-EPMC7949238 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians.

Attanasi Marina M Pasini Simone S Caronni Antonio A Pellegrino Giulia Michela GM Faverio Paola P Di Pillo Sabrina S Cimino Matteo Maria MM Cipolla Giuseppe G Chiarelli Francesco F Centanni Stefano S Sferrazza Papa Giuseppe Francesco GF

Respiration; international review of thoracic diseases 20200805 8

<h4>Background</h4>Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is of great global public health concern.<h4>Objective</h4>We explored the clinical management of inpatients with COVID-19 in Italy.<h4>Methods</h4>A self-administered survey was sent by email to Italian physicians caring for adult patients with COVID-19. A panel of experts was selected according to their clinical curricula and their responses were analyzed.<h4>Results</h4>A total of 1,215 physicians compl ...[more]

PMID: 32756065

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Project description:BackgroundGeneralized restriction of movement due to the COVID-19 pandemic, together with unprecedented pressure on the health system, has disrupted routine care for non-COVID-19 patients. Telemedicine should be vigorously promoted to reduce the risk of infections and to offer medical assistance to restricted patients.ObjectiveThe purpose of this study was to understand physicians' attitudes toward and perspectives of telemedicine during and after the COVID-19 pandemic, in order to provide support for better implementation of telemedicine.MethodsWe surveyed all physicians (N=148), from October 17 to 25, 2020, who attended the clinical informatics PhD program at West China Medical School, Sichuan University, China. The physicians came from 57 hospitals in 16 provinces (ie, municipalities) across China, 54 of which are 3A-level hospitals, two are 3B-level hospitals, and one is a 2A-level hospital.ResultsAmong 148 physicians, a survey response rate of 87.2% (129/148) was attained. The average age of the respondents was 35.6 (SD 3.9) years (range 23-48 years) and 67 out of 129 respondents (51.9%) were female. The respondents come from 37 clinical specialties in 55 hospitals located in 14 provinces (ie, municipalities) across Eastern, Central, and Western China. A total of 94.6% (122/129) of respondents' hospitals had adopted a telemedicine system; however, 34.1% (44/129) of the physicians had never used a telemedicine system and only 9.3% (12/129) used one frequently (≥1 time/week). A total of 91.5% (118/129) and 88.4% (114/129) of physicians were willing to use telemedicine during and after the COVID-19 pandemic, respectively. Physicians considered the inability to examine patients in person to be the biggest concern (101/129, 78.3%) and the biggest barrier (76/129, 58.9%) to implementing telemedicine.ConclusionsTelemedicine is not yet universally available for all health care needs and has not been used frequently by physicians in this study. However, the willingness of physicians to use telemedicine was high. Telemedicine still has many problems to overcome.

Project description:BACKGROUND:COVID-19 is a pandemic disease and questions rise about the coronavirus 2 (Sars-CoV-2) effect on nervous system. This involvement could help explaining the pathogenesis of this condition and lead to novel therapeutic approaches. OBJECTIVE:To assess the occurrence of neurological symptoms in COVID-19 patients during the Italian pandemic outbreak, as reported by physicians. MATERIALS AND METHODS:In the early days of pandemic emergence we developed an online survey open to all Italian clinicians involved in the diagnosis and management of COVID-19 patients. The survey was structured in three sections, with nine different items concerning the presence of different specific clinical abnormalities. Each item was graded from "absent" to "severe" in a 4-point Likert's scale. MAIN OUTCOMES AND MEASURES:Likert's scale data were analyzed by studying the distribution of responses by using medians and bar charts-relative frequencies. Also, in order to analyze differences in symptoms findings depending on the group of specialty, Likert's scale data were combined into two nominal categories ("absent"/"low" and "moderate"/"high"/") and a contingency table chi-square test was used. RESULTS:126 physicians of 9 different medical specialties, from 10 regions of Italy, filled the online survey. The results show that 87.3% of practitioners reported neurological symptoms. In most cases these were mild and non-specific, but they were severe in a minority of patients. The most common symptoms observed were headache, myalgia and taste and smell abnormalities. Whilst there was no difference between neurologists and non-neurologists, we found that experienced clinicians (defined as clinicians that evaluated more than 30 patients) reported neurological symptoms more frequently than non-expert. CONCLUSIONS:Neurological symptoms have frequently been ported during the Italian COVID-19 pandemic, and thus should be monitored for all affected patients. Whilst some of the disturbances reported may be non-specific and common to other infectious diseases, smell and taste abnormalities might indicate nervous system as entry door for SARS-CoV-2 virus. This interpretation should promote research trials to avoid nervous system involvement.

Dataset Information

Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians.

Background

Objective

Methods

Results

Conclusions

Publications

Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians.

Similar Datasets

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